Cross-sectional Study Research Articles

Knowledge level and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers attending Mkonze health center, Dodoma Region, Tanzania

BackgroundUnsafe abortion is now a global agenda because 45% of all global abortions are unsafe, and 97% are occurring in developing countries. In Tanzania, one million reproductive-aged women face unplanned pregnancies per year, and 39% end up with abortion. About 16% of maternal deaths are reported per year in Tanzania, and unsafe abortion takes the second position. There are several efforts to prevent and intervene unsafe abortions, such as equipping healthcare facilities across all levels of healthcare, approval of Misoprostol use, establishment of comprehensive post-abortion care (PAC), revising policy guidelines and standards, provision of emergency contraceptives, and capacity building of healthcare providers. There is little documentation about how the constructs of the theory of planned behaviour, knowledge, and sociodemographics influence the practice of abortion.ObjectivesTo assess the association of knowledge level, sociodemographic characteristics, and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers at Mkonze Health Center in the Dodoma region.MethodologyIt is an analytical cross-sectional study design conducted in Dodoma-Tanzania and involved 206 postnatal women. A validated questionnaire was used and analysis was performed in the Statistical Package for the Social Sciences (SPSS), through descriptive and inferential statistics.ResultsThe practice of unsafe abortion in the current study is 28/206 (13.6%), influenced bytheir lower educational level and being single women. It was found that the majority had adequate knowledge of unsafe abortion 129 (62.6%), positive attitude 130 (63.1%), good subjective norms 113 (54.9%), and positive perceived behavioral control111 (53.9%). Knowledge, attitude, subjective norms, and perceived behavioral control were not significantly associated with the practice of unsafe abortion.ConclusionThe majority of the respondents had high knowledge, attitudes, subjective norms, and perceived behavior control on unsafe abortion. This is an indicator that the implemented initiatives are effective. Maintaining the ongoing effort and improving strategies are promising to mitigate the burden of unsafe abortion. Future research needs to find out hidden factors associated with attitude and how health beliefs might influence someone’s attitude towards unsafe abortion.

Exploring the acceptance of robotic assisted surgery among the Indian population: An empirical investigation

Background Technology has completely transformed healthcare, starting with X-ray machines and MRIs to telehealth and robotic surgeries to e-health records. The launch of minimally invasive surgery (MIS) serves as a milestone in medical history, offering benefits such as smaller incisions, shorter hospital stays, and faster recovery, making it a preferred surgical option. This study mainly explores patients’ willingness to adopt robot-assisted surgery (RAS) technology in a surgical intervention and is assessed in the backdrop of the Technology Acceptance Model (TAM). Methods This research project employs a post-positivist research philosophy and a cross-sectional research design. A structured, pre-tested questionnaire was used to collect data from 280 respondents. Results The results revealed that trust had a significant impact on Perceived Usefulness (β = 0.099) and Perceived Ease of Use (β = .157), and eHealth literacy had a significant impact on Perceived Ease of Use (β = 0.438) and Perceived Usefulness (β = 0.454). Additionally, Perceived Usefulness partially influenced behavioral intention (β = 0.123), and attitude had a significant influence on behavioral intention (β = 0.612). The analysis revealed an insignificant impact of eHealth literacy on Perceived Usefulness (β = 0.067). The Standard Root Mean Square Residual (SRMR) value was <0.8. Mediation analysis also revealed partial mediation between the constructs. The SRMR rating of this model is 0.067, indicating that it fits the data well. Conclusion This study revealed that a patient's intention will be high if he or she believes that RAS is beneficial in treating his or her ailment. In comparison, information related to RAS is clearly known, and it does not directly affect selection intention. eHealth literacy is a significant antecedent to patients’ behavioral intention. Hence, the healthcare industry must devise strategies to promote the acceptance of RAS at all levels.

Relationships between Iron Status and Selected Physical Fitness Components of South African Adolescents: The PAHL-Study

Poor iron status is detrimental to physical and cognitive performance in adolescents. Due to the limited studies investigating the association between iron status and physical fitness components in adolescents from low- and middle-income countries, we aimed to determine the association of iron status with selected physical fitness components in South African adolescents. A cross-sectional study design, including 178 adolescents (102 girls and 76 boys) from the Physical Activity and Health Longitudinal Study (PAHLS), was followed. Height and weight were measured to calculate the body mass index (BMI). Subsequently, WHO BMI-for-age-specific categorised body fatness. Cardiorespiratory fitness was determined with a 20-m shuttle run test (V˙O2max), and lower-body explosive power by the standing broad jump (SBJ). Fasting haemoglobin (Hb) and ferritin were analysed from blood samples. Correlation analyses determine the association between iron status, explosive power and cardiorespiratory fitness. Of the 178 participants, 18.5% (n = 33) had low Hb, and 14% (n = 25) iron deficiency without anaemia. Significant positive correlations were found between the selected physical fitness components, ferritin, and Hb. In boys, a positive association was found between Hb and SBJ (r = 0.30, p = 0.006), whilst in girls, positive associations were found between ferritin (r = 0.25, p = 0.04) and SBJ, and Hb with both SBJ (r = 0.21, p = 0.03) and V˙O2max (r = 0.32, p = 0.001). Hb concentration remained associated with V˙O2max and SBJ in girls after adjustment for age, whilst in boys, Hb concentration was associated with SBJ. Higher iron status in South African adolescents is associated with higher lower-limb explosive power and cardiorespiratory fitness. We suggest monitoring of haematological parameters, and interventions to improve the iron status of South African adolescents.

Information-seeking behaviors, attitudes and beliefs about pregnancy-related nutrition and supplementation in different communities of Pakistan

Purpose This study aims to assess the information-seeking behaviors, attitudes and beliefs about pregnancy-related nutrition, food-related myths and taboos and supplementation among pregnant women in different communities of Pakistan. Design/methodology/approach A cross-sectional quantitative survey method was used in this study, which included 150 pregnant women from various locations in Lahore and Faisalabad. Findings Most participants were between the ages of 25 and 29, having 14 years of education. Regardless of age or number of children, all selected women had the same dietary awareness. Regarding myths and taboos, highly significant values (p = 0.001) were found in various studied variables. No significant difference was observed in knowledge level between age and number of children. It was observed that food myths and taboos significantly (p = 0.001) impact pregnant women’s dietary choices. Research limitations/implications This survey experienced limited representativeness; many participants provided incomplete food and nutritional information. This research was conducted in two major districts of Pakistan, i.e. Lahore and Faisalabad; therefore, the results can be generalized for a population of pregnant women living in the northeastern region of Pakistan. Practical implications This study can provide helpful insight for health-care professionals to improve pregnant women’s nutritional status and knowledge. Social implications The outcomes of this study can help guide how pregnant women might be educated and have better nutritional awareness at domestic and professional levels. Originality/value In Pakistan, there is a lack of research on pregnant women’s nutritional knowledge, and this research can assist health-care professionals in providing diversified knowledge to promote maternal health.

Utilization and associated determinants of multi-sectoral approach in zoonotic disease surveillance among animal and human healthcare workers in Nakuru County, Kenya

Background Zoonoses are naturally transmissible between humans and animals. Globally, they account for more than 60% of human infections, 75% of emerging infections, 2.7 million human deaths, and 10% of the total DALYs lost yearly in Africa. In the last three decades, Kenya has had sporadic outbreaks of zoonoses. To increase the speed of reporting and efficiencies in detection and control, a multi-sectoral collaboration in zoonotic disease surveillance (MZDS) between human and animal health workers is essential. In an effort, Zoonotic disease unit (ZDU) in Kenya has been established at national and county levels. Methods A cross sectional study was carried out to determine the level of utilization of multisectoral collaboration and its associated determinants in zoonotic disease surveillance among animal and human healthcare workers in Nakuru County. Quantitative data was gathered from 102 participants and quantitative data from 5 key informants. To test for significant differences, Chi-square and independent t-test were used. Results MZDS utilization level was 16% and the factors associated with higher utilization include; knowing what MZDS entails, education level, sector affiliation, trainings, supportive infrastructure and data storage. Lack of financing and poor coordination are hindrances to MZDS. Conclusion There is need to finance MZDS activities, strengthen coordination mechanisms, carry out more sensitization and trainings among animal and human healthcare.

Ocular effects of eye cosmetic formulations

ABSTRACT Objective To study the ocular effects seen among eye cosmetic wearers in the Indian Population. Methods This cross sectional study was conducted on female participants who had fulfilled the inclusion and exclusion criteria. A detailed history was obtained and thorough ophthalmic evaluation was done. Mann Whitney U test was used. Statistical analysis was done using IBM SPSS. p < 0.05 was taken as the level of statistical significance. Results Among a total of 225 participants in our study, the mean age was 24.23 ± 1.8 which comprised of young student females. Majority of the females used one eye cosmetics with Kajal (n = 156) being the most predominant. Most frequently encountered symptom upon using eye cosmetics was watering from eyes and ocular pain was the least encountered symptom. Anterior segment examination showed- allergic conjunctivitis and meibomian gland dysfunction being the most and least predominant respectively. Our study highlights that Kajal predisposes the eyes to significant ocular morbidity with p = 0.039 for Dry Eye Disease, p = 0.041 for Allergic Conjunctivitis, p = 0.036 for conjunctival pigmentation. Prolonged use of such formulations for more than 4 times a week (p = 0.046) or even daily(p = 0.031)for a duration of either 1-5 years (p = 0.033) or greater than 5 years (p = 0.027) was found to be statistically significant in causing ocular signs. Non removal of eye cosmetics at the end of the day was significant in causing allergic conjunctivitis (p = 0.035) and conjunctival pigmentation (p = 0.021). Plain tap water has been found to be the least effective technique in the removal of such ocular cosmetics with a statistical significance of p = 0.031 in causing ocular signs. Conclusions Eye cosmetics are a significant contributor to the development of ocular surface diseases. Removal of products along with decreased usage seems to be a significant contributor in dampening unwanted adverse effects.

The Effect of Mediterranean Diet on Thyroid Gland Activity

The main goal of this research was to determine whether there is a correlation between adherence to the Mediterranean diet (assessed by the Mediterranean Diet Serving Score (MDSS)) and parameters indicating thyroid gland activity, such as concentration of thyroid-stimulating hormone (TSH), thyroid hormones (free triiodothyronine (fT3), free thyroxine (fT4)), thyroglobulin (Tg), antibodies to thyroid proteins (thyroglobulin antibodies (TgAb) and thyroid peroxidase antibodies (TPOAb)), and calcitonin (CT) in plasma and serum samples. An additional objective was to investigate whether there are differences in the values of the MDSS among clinical groups (euthyroid individuals, euthyroid individuals with positive TgAb and/or TPOAb, and hypothyroid and hyperthyroid participants). This cross-sectional study included 4620 participants over 18 years of age from the islands of Korčula and Vis, and the mainland city of Split. The MDSS was assessed from a food frequency questionnaire (FFQ). MDSS values were significantly higher in females compared to males and showed a positive association with the age of the participants. There was no significant difference in the MDSS values among the examined clinical groups. In the group of subjects with euthyroidism, a significant positive association was found between fT3 and the MDSS, while in the group of subjects with subclinical hypothyroidism, a significant positive association was observed between the MDSS and both fT3 and fT4. CT levels were also positively associated with the MDSS. Considering the significant positive association of the MDSS and both fT3 and fT4 levels in patients with subclinical hypothyroidism, the results of this study could be used to create guidelines for selecting an appropriate, potentially protective diet for these patients.

Emotional Repercussions of Grandparents Facing the Illness and Treatment of Cancer in Pediatric Oncology at a Reference Hospital.

Childhood cancer, especially leukemias and central nervous system tumors, deeply impacts families, requiring important decisions during treatment. Parents, overwhelmed with increasing responsibilities, can rely on the crucial support of grandparents, both in providing significant emotional support and in actively participating in caring for their grandchildren, even if it affects their own daily activities and quality of life. Therefore, we sought to analyze the emotional repercussions of grandparents facing the illness and treatment of cancer. It was based on a qualitative cross-sectional study conducted at a reference hospital of the Unified Health System (SUS) in Pernambuco, Brazil, from December 2023 to February 2024. Data collection was performed through semi-structured and audio-recorded interviews, with participants' consent, transcribed in full, and analyzed using the Bardin technique. Five grandmothers participated in the study, all of them female, aged 52 to 68 years, with a mean age of 61.2 years. The study highlights the importance of grandparents in caring for their grandchildren, emphasizing the emotional challenges present in diagnosis and treatment.

Device-Related Skin Reactions Increase Emotional Burden in Youths With Type 1 Diabetes and Their Parents.

Skin reactions due to technological devices pose a significant concern in the management of type 1 diabetes (T1D). This multicentric, comparative cross-sectional study aimed to assess the psychological impact of device-related skin issues on youths with T1D and their parents. Participants with skin reactions were matched in a 1:1 ratio with a control group. Diabetes-related emotional distress was evaluated using the Problem Areas in Diabetes-Teen version (PAID-T) for participants aged 11 to 19 years and the Problem Areas in Diabetes-Parent Revised version (PAID-PR) completed by parents. In addition, glucose control was assessed through glycated hemoglobin (HbA1c) values and continuous glucose monitoring (CGM) metrics. A total of 102 children and adolescents were consecutively recruited. Adolescents with skin issues had higher PAID-T scores compared to those without (79.6 ± 21.1 vs 62 ± 16.8; P = .004). Parents of youths with skin reactions also reported higher PAID-PR scores than the control group (34.0 ± 11.0 vs 26.9 ± 12.3; P = .015). No differences were observed in HbA1c levels (6.9 ± 0.8% vs 6.8 ± 0.8%, P = .555) or CGM glucose metrics between the two groups. Remarkably, 25.5% were forced to discontinue insulin pumps and/or glucose sensors (21.5% and 5.9%, respectively). Our study highlighted the increased emotional burden experienced by youths with T1D and their parents due to device-related skin reactions, emphasizing the need for further research and interventions in this crucial aspect of diabetes management.

Eligibility for the medical therapy among men with non-obstructive azoospermia-Findings from a multi-centric cross-sectional study.

Existing literature does not provide accurate epidemiological data regarding the true prevalence of men with non-obstructive azoospermia (NOA) who would be eligible for hormonal optimization therapy, according to specific pre-treatment criteria. To investigate the characteristics of those men with NOA who would qualify for the medical therapy prior to any SR procedure in a large multi-centric cross-sectional study. Complete data from 1644 NOA patients seeking medical help for primary infertility at three tertiary referral centers from USA, Brazil, and Italy were analyzed. Baseline serum hormone levels were collected for all patients. NOA was confirmed after two consecutive semen analyses. Genetic tests, including karyotype analysis and Y microdeletions, were performed on all patients. Patients with secondary hypogonadism (total testosterone (T) levels less than 300ng/dL and luteinizing hormone (LH) levels less than 8 mIU/mL) were earmarked as potential candidates for receiving clomiphene citrate (CC) and/or human chorionic gonadotropin (hCG). Patients with a T to 17β-estradiol (E2) ratio<10 were classified as eligible for aromatase inhibitors (AIs) therapy (e.g., anastrazole). A third sub-cohort was created by combining the criteria of the first two sub-cohorts. Descriptive statistics was used to detail overall characteristics and differences between the different sub-cohorts. Among the 1,644 men, 28% (n=460) had T<300ng/dL and LH<8 mIU/mL, thereby being potentially suitable for CC and/or hCG, while 37% (n=607) had a T to E2 ratio<10 thus potentially suitable for AIs. Lastly, 17.7% (n=280) met the criteria for potential eligibility for both CC and/or hCG and AIs. Findings from this multicentric cross-sectional study reveal that about 30% of men with NOA were eligible for hormonal treatment with CC and/or hCG while 37% were found to be potential candidates for AIs, and 17% for both therapies. Therefore, these findings show that a only a small subset of NOA patients can benefit from medical therapy prior to considering any SR procedures.

Virtual reality simulation training in laparoscopic surgery – does it really matter, what simulator to use? Results of a cross-sectional study

BackgroundVirtual reality simulation training plays a crucial role in modern surgical training, as it facilitates trainees to carry out surgical procedures or parts of it without the need for training “on the patient”. However, there are no data comparing different commercially available high-end virtual reality simulators.MethodsTrainees of an international gastrointestinal surgery workshop practiced in different sequences on LaparoS® (VirtaMed), LapSim® (Surgical Science) and LapMentor III® (Simbionix) eight comparable exercises, training the same basic laparoscopic skills. Simulator based metrics were compared between an entrance and exit examination.ResultsAll trainees significantly improved their basic laparoscopic skills performance, regardless of the sequence in which they used the three simulators. Median path length was initially 830 cm and 463 cm on the exit examination (p < 0.001), median time taken improved from 305 to 167 s (p < 0.001).ConclusionsAll Simulators trained efficiently the same basic surgery skills, regardless of the sequence or simulator used. Virtual reality simulation training, regardless of the simulator used, should be incorporated in all surgical training programs. To enhance comparability across different types of simulators, standardized outcome metrics should be implemented.

Linking patient-reported oral and general health-related quality of life

Background The relationship between oral and overall health is of interest to health care professionals and patients alike. This study investigated the correlation between oral health-related quality of life (OHRQoL) and health-related quality of life (HRQoL) in a general adult population. Methods This cross-sectional study used a convenience sample of adult participants (N = 607) attending the 2022 Minnesota County and State fairs in USA, the 5-item Oral Health Impact Profile (OHIP-5) assessed OHRQoL, and the 10-item PROMIS v.1.2 Global Health Instrument assessed HRQoL. Spearman and Pearson correlations were used to summarize the bivariable relationship between OHRQoL and HRQoL (both physical and mental health dimensions). A structural equation model determined OHRQoL-HRQoL correlations (r). Correlations’ magnitude was interpreted according to Cohen’s guidelines (r = 0.10, 0.30, and 0.50 to demarcate “small,” “medium,” and “large” effects, respectively). Results OHRQoL and HRQoL correlated with r = 0.52 (95% confidence interval, CI: [0.50–0.55]), indicating that the two constructs shared 27% of their information. According to Cohen, this was a “large” effect. OHRQoL, and the physical and mental HRQoL dimensions correlated with r = 0.55 (95% CI: [0.50–0.59]) and r = 0.43 (95% CI: [0.40–0.46]), respectively, indicating a “large” and a “medium” effect. OHRQoL and HRQoL were substantially correlated in an adult population. Conclusion Using OHIP-5 to assess their dental patients’ oral health impact allows dental professionals to gain insights into patients’ overall health-related wellbeing.

Post-traumatic stress disorder symptoms among internally displaced persons: unveiling the impact of the war of Tigray

IntroductionDue to the war in Tigray, 2.1 million people (31% of the total population) were internally displaced. Epidemiological evidence shows that the burden of mental health is higher in war/conflict and post-conflict areas of the world compared to non-conflict places, especially for those who have experienced targeted ethnic violence as a result of civil and political unrest. Post-traumatic stress disorder is one of the common psychiatric disorders experienced during war. Thus, this study aimed to assess the level and aggravating factors of PTSD during the war in Tigray.MethodsA community-based cross-sectional study was conducted among 2132 IDP family heads in Tigray from August 6–30, 2021. Study participants were recruited using a multi-stage sampling technique. Data were collected using a pretested structured questionnaire through face-to-face interviews. The PCL-C checklist, derived from DSM-IV criteria, was used to assess the magnitude of post-traumatic stress disorder. The entered data were exported to the SPSS version 26 statistical package for analysis. Summary statistics were computed, and logistic regression analysis was used to investigate factors associated with developing PTSD.ResultsA total of 2071 IDPs were surveyed with a response rate of 99.7%. The survey revealed that the level of PTSD among community-hosted IDPs was 57.7%; 95% CI 55.5%-59.8%. Older age (> 50) (AOR 3.1, 95% CI 1.497–6.421), primary and secondary school attendance (AOR 2.1, 95% CI 1.344–3.279; and 1.697, 95% CI 1.067–2.7) respectively, internally displaced persons with a family size of > 6 members (AOR 1.821, 95% CI 1.124–2.95), disability due to the war (AOR 1.702, 95% CI 1.077–2.69), and loss of contact with family members (AOR 1.472, 95% CI 1.032–2.099) were significantly associated with PTSD.ConclusionThe overall level of PTSD among cIDPs was found to be high (57.7%). Almost every other IDP developed this serious mental health syndrome. Immediate psycho-social health intervention is needed by local and international organizations in collaboration with governmental and non-governmental institutions based on the study's findings.

Access to Contraceptives among Venezuelan Migrant Women Residing in Peru: Analysis on a Population-Based Survey.

Introduction: The emigration of Venezuelans has seen a significant increase in recent years. The aim of this study was to identify factors associated with access to contraceptives in migrant women from Venezuela residing in Peru. Methods: An exploratory cross-sectional study was conducted using data from the Second Survey of the Venezuelan Population Residing in Peru. Access to contraceptives (yes/no) was established as the dependent variable. A Poisson regression model was performed for complex samples, and crude (PRc) and adjusted (PRa) prevalence ratios were reported. Results: A total of 3617 migrant women were analyzed, with 50.12% reporting access to contraceptives. Factors associated with greater access to contraceptives included being between 20 to 29 years old, having a university education, the entry period after the declaration of COVID-19 quarantine was associated with lower access to contraceptives. Conclusions: Access to contraceptives for Venezuelan migrants should be provided to all, as it is a free service in Peru. Additionally, education and family planning should be provided from the basic or middle school level to prevent unintended pregnancies in the future. Complete coverage should be provided regardless of the time of entry into Peru.

Dietary risk assessment of drinking water and fish from cultivated wetlands of Ndop

ABSTRACT This study evaluated pesticide exposure practices, and the potential health risks of consuming drinking water and fish from the cultivated wetlands of Ndop, Cameroon. Six hundred and twenty-six questionnaires were conveniently administered to farmers (≥26 years old) in a cross-sectional study to assess exposure practices and dietary risks. The Chi-square and Pearson correlation coefficients were used to establish relationships between variables. The PRIMET model was used to predict a worst-case dietary risk. The exposure practices of 90% of farmers were inadequate. Chlorpyriphos, lambda-cyhalothrin, fipronil, and paraquat dichloride posed a possible dietary risk at recommended and applied doses, with chlorpyrifos having the highest exposure toxicity ratio (ETRdiet = 36.72). Paraquat dichloride, fipronil, and lambda-cyhalothrin posed a possible dietary risk at 26.3, 58.3, and 62.2% of their recommended concentrations, respectively. Remarkably, the dietary risk for cypermethrin was acceptable at 5.8 times its recommended dose (ETRdietR = 0.29). The significant positive correlation (p = 0.000) between PECfish and ETRdiet suggests a possible health risk of consuming fish and drinking water harvested from the wetlands, thus the urgent need of replacing pesticides posing possible risks at lower or recommended concentrations with less toxic alternatives and to train farmers on pesticide application practices.

Quality of Life and its sociodemographic determinants: a population-based study from rural Punjab, India

BackgroundQuality of Life (QoL) is an individual’s subjective perception of well-being within their cultural context. While most QoL studies focus on individuals with certain health conditions, factors such as sex, marital status, education, and family structure can influence QoL beyond age and health conditions. Considering the limited studies on QoL in the general Indian population, especially from rural areas, the present study aims to explore the QoL and sociodemographic factors affecting QoL among community-dwelling adults in rural Punjab.MethodsThis community-based cross-sectional study was conducted among 931 individuals of both sexes (59.6% female) aged 20–75 years residing in rural areas of Mansa, Punjab, India. Sociodemographic data were collected using an interview schedule, and QoL was measured using the WHOQOL-BREF.ResultsThe overall mean QoL score was found to be 67.44 ± 14.7. The most affected QoL was in the physical domain (mean = 60.203 ± 13.49), followed by psychological (mean = 65.67 ± 18.3), social-relationship (mean = 69.88 ± 26.43), and environmental domains (mean = 74.05 ± 20.58). Adjusted logistic regression analysis revealed female sex, advanced age (age group ≥ 60 years), illiteracy, and unmarried status to be positively associated and family size of 6–10 members to be negatively associated with poor QoL.ConclusionThe study suggests that females, elderlies, illiterates, and unmarried individuals may be at a higher risk of poor QoL. Further, education and a bigger family size appear to increase subjective well-being among participants.

The Effect of Antibiotic Therapy Before Percutaneous Nephrolithotomy on the Frequency of Postoperative Complications: A Retrospective Cross-Sectional Study

Background: Percutaneous nephrolithotomy (PCNL) is commonly used in the treatment of large renal stones. Postoperative infections are a common consequence of these procedures. Objectives: The purpose of this study is to evaluate the effects of antibiotic therapy before PCNL on the possibility of developing fever and common complications after the procedure. Methods: We carried out a retrospective cross-sectional study involving 708 patients who had undergone PCNL at Razi Hospital in Rasht, covering the period from 2012 to 2022. Patients were allocated into two groups: Group 1 included 454 patients who had received antibiotic therapy, and group 2 included 254 patients who had not received pre-operative antibiotic therapy. Results: In group 1, there were 241 males (53.1%) and 213 females (46.9%), while in group 2, there were 138 males (54.3%) and 116 females (45.7%). In group 1, 82.7% of patients treated with antibiotics had a negative culture. The hospitalization time was 4.00 ± 1.75 days for group 1 and 2.26 ± 1.56 days for group 2. Fever was observed in 39 patients (11.2%) in group 1. Sepsis was seen in only one patient (0.3%) in group 1. There is a significant relationship between total hospitalization time (P = 0.000), hospitalization after the operation (P = 0.000), hypertension (P = 0.009), ischemic heart disease (P = 0.050), history of shock wave lithotripsy (P = 0.003), hydronephrosis (P = 0.000), age (P = 0.004), and hemoglobin levels (P = 0.000) with antibiotic therapy. Conclusions: Surgeon overprescription of antibiotics may lead to resistance, complicating outcomes and extending hospital stays after PCNL. Some complications remain unaffected by antibiotic therapy due to surgical experience.

Knowledge, attitude, and practice regarding dengue among non-health undergraduate students of Nepal.

Dengue poses a significant public health concern worldwide. It is identified as a recent emerging infectious disease in Nepal. Understanding the situation and dynamics between knowledge, attitudes, and practices (KAP) related to dengue among students is crucial for effective prevention and control strategies. This study aimed to assess the KAP and their associated factors of dengue among non-health undergraduate students of Nepal to identify gaps and suggest appropriate interventions. A web-based cross-sectional study was conducted among 429 non-health undergraduate students at eleven Nepalese Universities, with 80% of participants from the four most prominent ones in the country. Self-administered online forms were administered via Google Forms platform predominantly through social media for data collection. Data was cleaned and then exported to IBM SPSS Statistics 20.0 for analysis. Demographic characteristics of respondents were described using descriptive statistics. Multivariate logistic regression was conducted to determine the association between individual characteristics and KAP. Pearson's correlation coefficient was used to determine the association between knowledge-attitude, attitude-practice, and knowledge-practice. Statistical significance was determined at the p-value < 0.05. Around half of the participants were female (50.3%). The majority of participants were between 22 to 37 years, unmarried, and belonged to the Brahmin/Chhetri ethnic group. This study demonstrated a significant gap in KAP. Only 15.2% of participants had good knowledge while 25.9% and 68.3% of participants exhibited good attitudes and practices respectively. Marital status (AOR = 3.32, CI: 1.32-8.34), third-year educational level (AOR = 3.59, CI:1.34-9.57), and fourth-year educational level (AOR = 4.93, CI:1.88-12.94) were significantly associated with knowledge regarding dengue. Age (AOR = 1.73, CI: 1.10-3.01) was significantly associated with preventive practice regarding dengue. None of the demographic or socio-economic characteristics of respondents was associated with attitude on dengue. The knowledge-attitude (rka = 0.01), knowledge-practice (rkp = 0.22), and attitude-practice (rap = 0.01) were positively correlated in this study.

Prenatal Exposures, Diagnostic Outcomes, and Life Experiences of Children and Youths with Fetal Alcohol Spectrum Disorder

Children and youths diagnosed with FASD may experience a range of adverse health and social outcomes. This cross-sectional study investigated the characteristics and outcomes of children and youths diagnosed with FASD between 2015 and 2018 at the Sunny Hill Centre in British Columbia, Canada and examined the relationships between prenatal substance exposures, FASD diagnostic categories, and adverse health and social outcomes. Patient chart data were obtained for 1187 children and youths diagnosed with FASD and analyzed. The patients (mean age: 9.7 years; range: 2–19) had up to 6 physical and 11 mental health disorders. Prenatal exposure to other substances (in addition to alcohol) significantly increased the severity of FASD diagnosis (OR: 1.18): the odds of FASD with sentinel facial features (SFF) were 41% higher with prenatal cigarette/nicotine/tobacco exposure; 75% higher with exposure to cocaine/crack; and two times higher with exposure to opioids. Maternal mental health issues and poor nutrition also increase the severity of FASD diagnosis (60% and 6%, respectively). Prenatal exposure to other substances in addition to alcohol significantly predicts involvement in the child welfare system (OR: 1.52) and current substance use when adjusted for age (aOR: 1.51). Diagnosis of FASD with SFF is associated with an increased number of physical (R2 = 0.071, F (3,1183) = 30.51, p = 0.000) and mental health comorbidities (R2 = 0.023, F (3,1185) = 9.51, p = 0.000) as compared to FASD without SFF adjusted for age and the number of prenatal substances. Screening of pregnant women for alcohol and other substance use, mental health status, and nutrition is extremely important.

Spirometry Interpretation After Implementation of Race-Neutral Reference Equations in Children.

The implications of adopting race-neutral reference equations on spirometry interpretation in children remain unknown. To examine how spirometry results and patterns change when transitioning from Global Lung Function Initiative (GLI) race-specific reference equations (GLIR, 2012) to GLI race-neutral reference equations (GLIN, 2023). Cross-sectional study of spirometry tests conducted in children aged 6 to 21 years between 2012 and 2022 at 2 large academic pediatric institutions in the US. Data were analyzed from September 2023 to March 2024. Data on participant characteristics and raw test measurements were collected. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC z scores and percent predicted were calculated using both GLIR and GLIN. In addition, test results were categorized into normal, obstructive, suspected restrictive, mixed, suspected dysanapsis, and uncategorized patterns based on z scores calculated using GLIR or GLIN. For each spirometry result, the difference between z scores and percent predicted when transitioning from GLIR to GLIN was calculated. The proportion of tests with a normal pattern and individual spirometry patterns changed by GLI reference equation applied were also examined. Data from 24 630 children were analyzed (mean [SD] age, 12.1 [3.8] years). There were 3848 Black children (15.6%), 19 503 White children (79.2%), and 1279 children of other races (5.2%). Following implementation of GLIN, FEV1 and FVC z scores decreased in Black children (mean difference, -0.814; 95% CI, -0.823 to -0.806; P < .001; and -0.911; 95% CI, -0.921 to -0.902; P < .001, respectively), while FEV1 and FVC z scores slightly increased (0.073; 95% CI, 0.069 to 0.076; P < .001). Similar changes were found when using percent predicted. In Black children, the number of tests with a normal pattern decreased from 2642 (68.7%) to 2383 (61.9%) (χ21 = 204.81; P < .001), mostly due to tests with a normal pattern transitioning to a suspected restrictive or uncategorized pattern. Opposite, albeit smaller, changes in spirometry results and patterns were seen in White children. In adjusted models, Black children had approximately 3-fold higher odds than White children of changing spirometry pattern following the implementation of GLIN (adjusted odds ratio, 3.15; 95% CI, 2.86 to 3.48; P < .001). Pronounced differences in spirometry results and patterns were found when switching between GLI reference equations, which markedly differed by race. These findings suggest that the implementation of GLIN is likely to change the treatment of children with chronic lung diseases that are more prevalent in underrepresented minorities, such as asthma.